1Department of Neurosurgery.
2Advocate Bromenn Medical Center, Normal, Illinois.
J Neurosurg Pediatr. 2020 Dec 18;27(3):253-258. doi: 10.3171/2020.7.PEDS20403. Print 2021 Mar 1.
Stereotactic electroencephalography (SEEG) is an increasingly common technique that neurosurgeons use to help identify the epileptogenic zone. The anchor bolt, which typically secures the electrode to the skull, can be problematic in very thin bone or in electrodes placed in the occiput.
A technique is described to place electrodes without the use of an anchor bolt. Accuracy data for entry point, target point, and depth were collected and compared between electrodes placed with and those placed without an anchor bolt.
A total of 58 patients underwent placement of 793 electrodes, of which 25 were boltless. The mean entry and depth errors at target were equivalent, although there was a trend toward greater depth error with boltless electrodes (3.4 mm vs 2.01 mm and 2.59 mm in the bolted groups, respectively). The mean lateral target error was slightly but significantly smaller for boltless electrodes. The majority (60%) of boltless leads were placed into thin temporal squamous bone. The average skull thickness at the entry point for all boltless leads was 1.85 mm.
Boltless SEEG electrodes can be placed through thin bone, adjacent to a cranial defect, or in the occiput with equivalent accuracy to electrodes placed with anchor bolts.
立体定向脑电图（SEEG）是神经外科医生越来越常用的一种技术，用于帮助确定致痫区。固定电极的锚定螺栓在非常薄的骨或在后颅窝放置电极时可能会出现问题。
描述了一种不使用锚定螺栓放置电极的技术。收集了有和没有使用锚定螺栓的电极的进针点、靶点和深度的准确性数据，并进行了比较。
共有 58 例患者接受了 793 个电极的植入，其中 25 个是无螺栓电极。靶点的平均进针和深度误差相当，尽管无螺栓电极的深度误差有增加的趋势（分别为 3.4 毫米、2.01 毫米和 2.59 毫米）。无螺栓电极的平均横向靶点误差略小，但具有显著意义。大多数（60%）无螺栓导联被植入到薄的颞鳞骨中。所有无螺栓导联的平均颅骨厚度在进针点为 1.85 毫米。
无螺栓 SEEG 电极可以穿过薄骨、靠近颅骨缺损或在后颅窝放置，其准确性与使用锚定螺栓的电极相当。
